Methods and materials for assessing homologous recombination deficiency

A method of treating cancer, comprising:

• (1) assaying a first specimen comprising a cancer cell obtained from a cancer patient to determine whether the specimen harbors a deleterious mutation in either the BRCA1 gene or the BRCA2 gene, wherein assaying in (1) comprises
• (a) extracting genomic DNA from the specimen into a sample;
• (b) enriching the sample for DNA molecules whose collective sequence comprises the coding regions of the BRCA1 gene and the BRCA2 gene;
• and
• (c) sequencing the DNA molecules in (1)(b) or DNA molecules derived therefrom;
• (2) assaying either the first specimen in (1) or a second specimen comprising a cancer cell obtained from the cancer patient to detect a number of Indicator LOH Regions, a number of Indicator TAI Regions, and a number of LSTs in at least ten pairs of human chromosomes of the cancer cell,
• (a)(i) wherein an Indicator LOH Region is a region of loss of heterozygosity equal to or longer than a first length but shorter than the length of the whole chromosome containing the Indicator LOH Region, and wherein the first length is at least 1.5 megabases;
• (a)(ii) wherein an Indicator TAI Region is a region of allelic imbalance that extends to one of the subtelomeres, does not cross the centromere and is equal to or longer than a second length that is at least 1.5 megabases;
• (a)(iii) wherein the number of LST breakpoints is the number of copy number transitions along the length of a chromosome located between two regions, each longer than a third length that is at least 5 megabases, after filtering out copy number transitions along the length of a chromosome located between two regions, each shorter than a fourth length that is at most 4 megabases;
• and
• (b) wherein assaying in (2) comprises analyzing DNA molecules each comprising at least one locus from a plurality of single nucleotide polymorphism loci to determine the genotype at each such locus, wherein the plurality of single nucleotide polymorphism loci comprises at least 1,000 single nucleotide polymorphism loci and wherein there is at least one single nucleotide polymorphism locus located on average every 500 kb within each chromosome of the ten pairs of human chromosomes;
• (3) determining a test value equal to or derived from the arithmetic mean of the number of Indicator LOH Regions, the number of Indicator TAI Regions and the number of LST breakpoints detected in (2);
• and
• (4) administering either
• (a) a treatment regimen comprising a platinum agent or PARP inhibitor to a patient in whose specimen either (i) a deleterious mutation in either the BRCA1 gene or the BRCA2 gene is detected in (1) or (ii) the test value in (2) is greater than a reference value equal to or derived from the arithmetic mean of the number of Indicator LOH Regions, the number of Indicator TAI Regions and the number of LST breakpoints detected in cancer cell specimens of a population of reference cancer patients, wherein the reference value is 5 or greater;
• or
• (b) a treatment regimen excluding a platinum agent or PARP inhibitor to a patient in whose specimen neither (i) a deleterious mutation in either the BRCA1 gene or the BRCA2 gene is detected in (1) nor (ii) the test value in (2) is greater than a reference value equal to or derived from the arithmetic mean of the number of Indicator LOH Regions, the number of Indicator TAI Regions and the number of LST breakpoints detected in cancer cell specimens of a population of reference cancer patients, wherein the reference value is 5 or greater.